PURPOSE: We tried to outline the incidence and characteristics of meniscal tears in recent lesions and chronic insufficiency of the ACL. MATERIALS AND METHODS: Through this retrospective study of 103 reconstructions of the anterior cruciate ligament (ACL) performed between Jun 1996 to Sep 1998, according to a more accurate evaluation, ACL-deficient knees can be classified into two different stages (recent, chronic injuries). RESULTS: Overall, there was a significantly increasing incidence of meniscal tears in chronic injuries (P<0.05). A predominance of lateral meniscal tears were demonstrated with recent injuries, whereas the incidence of medial meniscal tears increased significantly with chronic injuries (P<0.05). CONCLUSIONS: This study highlights the increase of lateral meniscal lesion in recent ACL rupture and increase of severe meniscal lesion, especially medial meniscus, with progressive worsening of knee instability after an ACL injury. Although not significant, meniscal tears in the recent injuries were more amenable to repair. The results suggest that maximal meniscal preservation is best achieved with ACL reconstruction shortly after injury.
Anterior Cruciate Ligament* ; Incidence ; Knee* ; Menisci, Tibial ; Retrospective Studies ; Rupture*

PURPOSE: Recently, there are many good reports on the arthroscopic management of tibial condylar fractures. But, it may be appropriate for selected tibial condylar fractures and also needs a skilled technique. So we report the results of the tibial condylar fractures treated by the arthroscopy and limited percutaneous fixation or the arthroscopic-assisted management with conventional internal fixation without arthrotomy. MATERIALS AND METHODS: From June 1996 to December 1997, we treated 22 cases of the tibial condy- lar fractures including relatively comminuted one and analysed the results of patients who have been observed at least 1 year with Porters knee evaluation criteria. RESULTS: In 18 out of 22 cases, the results were Acceptable on symptoms(excellent 3, good 15, fair 4), in 18, on function(excellent 10, good 8, fair 3), in 21, on appearance(excellent 12, good 9, fair 1) and in 20, on radiographic appearance(excellent 11, good 9, fair 2). Overall results were Acceptable in 18 cases(82%) and Unacceptable in 4 cases(18%). CONCLUSION: The arthroscopic-assisted management with conventional internal fixation without arthrotomy can be the recommendable treatment for the tibial condylar fractures, including relatively comminuted one, without complications.
Arthroscopy ; Humans ; Knee

TGF-p receptor mutation is now considered as one of the carcinogenic process of many tumors. To evaluate whether there is an abnormality in TGF-p type II receptor in osteosarcoma cell lines, we performed Northern analysis, cross-linking assay, luciferase activity and TGF-p growth inhibition assay in four osteosarcoma cell lines: G292, U202, HOS and SaOS. We also transfected the tumor cells with normal TGF-p type II receptor sequence to find if there is a possibility of gene therapy in osteosarcoma. In Northern analysis, Type II receptor expressions were decreased at SaOS, U202 and HOS cell lines. In cross-linking assay, all four cell lines didnt show type II receptor at their cell surface. The growth of these tumor cells were not suppressed by TGF-p. From these findings, we concluded that the normal production of TGF-p type II receptor was impaired in osteosarcoma. The transfection of these tumor cells with normal type II receptor sequence restored growth inhibition by TGF-p. This means even though TGF-p type II receptor is abnormal in osteosarcoma, we can restore its function by transfection of normal sequence. We think that the TGF-p type Il receptor gene therapy can be one of the treatment method for osteosarcoma in the future.
Cell Line* ; Genetic Therapy ; Luciferases ; Osteosarcoma* ; Transfection

Transforming growth factor-beta (TGF-beta) has been suspected as a possible gene therapy candidate for orthopedic diseases. We demonstrated that the TGF-beta gene therapy can be applicable to orthopedic patients. After transfection of TGF-beta cDNA sequence to myoblasts [C2 (280)] and fibroblasts (NIH 3T3), stable cell lines with TGF-beta mRNA expression were selected by Northern analysis. To evaluate the possibility of clinical application of these cells to orthopedic diseases, the cells were injected into rabbit achilles tendon. Intratendinous injection was done to evaluate the viability of the cells and to determine the optimal concentration for in vivo expression. At 6 weeks after injection, the injected tendon was thickened with newly formed collagen. The results from this experiment indicates that these cells survived and stimulated matrix formation in rabbit achilles tendon. We concluded that TGF-beta cDNA transfected cells can be useful in the evaluation of TGF-beta biology in vivo.
Achilles Tendon* ; Biology ; Cell Line* ; Collagen ; DNA, Complementary ; Fibroblasts* ; Genetic Therapy ; Humans ; Myoblasts* ; Orthopedics ; RNA, Messenger ; Tendons ; Transfection ; Transforming Growth Factor beta*

STUDY DESIGN: This retrospective study is to confirm the diagnostic accuracy of percutaneous needle biopsy of vertebral lesions. OBJECTIVES: To evaluate the diagnostic accuracy of percutaneous needle biopsy and the clinical and pathological correlation of vertebral lesions. SUMMARY OF LITERATURE REVIEW: A review of previous articles showed that the diagnostic accuracy of percutaneous needle biopsy of vertebral lesions was between 77-94%. The greatest accuracy was achieved in diagnosis of metastatic disease or infection. MATERIALS AND METHODS: We performed 22 percutaneous needle biopsies in twenty vertebral bodies and two posterior elements under the CT guidance. All biopsies were performed with a 16-gauge Osty-cut bone biopsy needle. There were 1 cervical, 8 thoracic and 13 lumbar biopsies. Transpedicular approach was performed on 13 patients and paraspinal approach on 7 patients. There were 8 malignancies, 9 infections, 2 benign tumors, 2 compression fractures and 1 butterfly vertebra. RESULTS: An accurate diagnosis was made in 18 cases(81.8%) of all cases. Two of the 22 specimens were blood clots and two specimens of tuberculous spondylitis were insufficient for definite diagnosis. Bacteriological studies revealed a causative agent in 43% of pyogenic spondylitis. Histologic diagnosis confirming the clinical suspicion was obtained in 16(80%) of the 20 positive cases. There was no complication. CONCLUSION: Percutaneous needle biopsy under the CT guidance is a safe and accurate method for obtaining a diagnosis of vertebral lesions such as osteolytic lesion and infection.
Biopsy ; Biopsy, Needle* ; Butterflies ; Diagnosis ; Fractures, Compression ; Humans ; Needles* ; Retrospective Studies ; Spine ; Spondylitis

PURPOSE: To report the differences between previous articles in Korea on the common occurence of lateral meniscus tears and our cases, and also which clinical symptoms and signs are the most reliable for diagnosis of meniscal tear. MATERIALS AND METHODS: We analysed 118 patients who were confirmed to have a meniscal tear by arthroscopy from May 1996 to May 1998. The Chi-Square test was used for statistical analysis. RESULTS: There is no statistical difference of frequency between tears of the medial meniscus and those of the lateral meniscus. The most frequent clinical symptom is feeling of subluxation and sign is McMurray test. A combination of McMurray and squatting test is the most frequent positive sign of meniscal tear in our cases. CONCLUSIONS: In our cases, the frequency of medial meniscus tears is more common than those of the previous articles in Korea. To increase the accuracy of clinical diagnosis of meniscal tear, repeated and accurate history taking and physical examination, including above symptoms and signs are very important.
Arthroscopy ; Diagnosis* ; Humans ; Knee Joint* ; Knee* ; Korea ; Menisci, Tibial ; Physical Examination

PURPOSE: The purpose of this study is to present the usefulness of arthrometer (KT-2000) in patients with anterior knee instability and to assist in evaluating an objective prognosis after anterior cruciate ligament reconstruction. MATERIAL AND METHOD: We analyzed the manual maximum anterior displacement, passive anterior displacement at 30Ib force and compliance index between 15Ib and 30Ib, measured by KT-2000 in 82 cases of patient who had unilateral anterior knee instability and 40 cases of volunteers, as control group, who had no history of knee injury. We used the Paired and Independent t-test for statistical analysis. RESULTS: In control group, the mean value of manual maximum anterior displacement is 0.8 +/- 0.9mm, passive anterior displacement, 1.4 +/- 1.3mm and compliance index, 1.1 +/- 1.1mm. In patient group, the mean value of manual maximum anterior displacement is 7.1 +/- 2.7mm, passive displacement, 6.1 +/- 2.6mm and compliance index, 3.8 +/- 1.8mm. We found that the patient group was revealed much higher degree of anterior displacement than the control group (p<0.005) . CONCLUSION: KT-2000 is objective and quantitative in diagnosis of anterior knee instability.
Anterior Cruciate Ligament Reconstruction ; Compliance ; Diagnosis ; Humans ; Knee Injuries ; Knee* ; Prognosis ; Volunteers

PURPOSE: We report the results of arthroscopic ACL reconstruction using a bone-patellar tendon-bone (BPTB) autograft and a bioab-sorbable interference screw (Bioscrew, poly L-lactic acid, Linvatec co., USA). MATERIALS AND METHODS: From January 1998 to December 1998, we performed 39 cases of arthroscopic ACL reconstruction using BPTB autograft and a bioabsorbable interference screw. The average follow-up period was 2 years and 8 months. We performed KT-2000 testing and measured the IKDC, Tegner and Lysholm scores preoperatively and compared these with the results of a final evalua-tion. We performed second-look arthroscopy on 4 cases and observed the degree of degradation of the bioabsorbable interference screw. RESULTS: Preoperative evaluation revealed an average range with a KT-2000 of 8.1 +/-3.4 mm, a Lysholm score of 66.2 +/-16.3, an IKDC score below C in all cases and a Tegner score of 3.7 +/-0.9, but final results showed a KT-2000 of 2.8 +/-2.2 mm, a Lysholm score of 91.7 +/-7.5, an IKDC score above B in all except 3 cases and a Tegner score of 6.9 +/-1.1. Second-look arthroscopy at 3 and 12 months post-operatively showed no degradation of the bioabsorbable interference screw, but there was partial degradation of the bioabsorbable inteference screw at 21 and 33 months. CONCLUSION: Bioabsorbable interference screws seems a reasonable alternative to metallic screws in ACL reconstruction. Bioab-sorbablescrew implanted in humans may take much longer to degrade than expected, more study is needed.
Arthroscopy ; Autografts* ; Follow-Up Studies ; Humans ; Lactic Acid

PURPOSE: This study was designed to clarify the osseointegration of the titanium screw coated with CMP, in regard to the time schedule, through the characteristic of early osseointegration. MATERIALS AND METHODS: Mechanical, radiological and histomophometric measurements were performed in 28 rabbit tibial proximal metaphyseal cortical bone screws 6, 12, 26 and 52 weeks after surgery for the in vivo comparison of the osseointegration of titanium screws (3.75 mm diameter, 5 mm length) with different surface treatments: CMP coating group, with the sol-gel method (experimental group) and uncoated group (control group). RESULTS: 1. Radiology: There were no differences between the two groups without a radiolucent line or in regard to the time schedule. 2. Histology: There were no differences between the two groups without a fibrous tissue intervening surface or in regard to the time schedule. 3. Torque test: The test results for the CMP coated group were 1.5 times higher than those for the uncoated group, which was statistically meaningful, but there was no difference in regard to the time schedule. CONCLUSION: CMP coating is an option to increase the osseointegration of the titanium screw.
Appointments and Schedules ; Bone Screws ; Ceramics* ; Osseointegration* ; Tibia ; Titanium ; Torque

PURPOSE: Of all meniscal tears, isolated meniscal tear accounted for about 20%~30%. Also only a few reports in the literature dealt with isolated meniscal tear, which has a lower repairability and healing rate compared to patients with meniscal tear associated with ACL rupture. This study was undertaken to evaluate the clinical characteristics of isolated meniscal tear. MATERIALS AND METHODS: Between June, 1996 and May, 1999, 170 cases confirmed to have a meniscal tear by arthroscopy, were included in this study. We analysed clinical characteristics, according to the type of injury, medial meniscal tear versus lateral meniscal tear, type and site of meniscal tear, as well as possibility of repair. RESULTS: The frequency of medial meniscus tear is more common than that of lateral meniscus tear. Additionally, the most common cause of meniscal tear was non- contact injury. Of the total isolated meniscal tears, 20.5% were repaired. CONCLUSION: In our case, the incidence of medial meniscus tear is higher than that of the lateral meniscus tear, but this study noted a significantly low incidence of repairablity in isolated meniscal tear. Based on preliminary findings in this study, we consider degenerative change of meniscus as the most important factor explaining the clinical characteristics of meniscus tear in patients, especially, over the age of 30.
Arthroscopy ; Humans ; Incidence ; Menisci, Tibial ; Rupture